What Kind of Donors Are There?

Deceased Donors

Brain Dead: Brain Death is defined as the irreversible cessation of all brain function including the brain stem. The patient is declared dead by neurologic criteria and the time of the second exam becomes the legal time of death. Brain dead donors can donate solid organs, corneas and tissues.

Donation After Cardiac Death (DCD): DCD is defined as a procedure in which organs are surgically recovered following the pronouncement of death based on the clinical findings of irreversible cessation of circulation or blood flow. The Attending Physician or designee, according to hospital protocol, withdraws life-sustaining interventions. This can take place in the operating room and the family can be present when the patient cardiac arrests. DCD donors can donate livers, kidneys, lungs, pancreas and tissues.

Tissue Donor Only (in the event of cardiac death): Can donate eyes/corneas and tissues that include cardiovascular and connective tissue, bone and skin.

What Is My Role After I Have Made the Call?

Maintain the patient hemodynamically. Organ donation can only occur if the organs are kept viable through mechanical ventilation and vascular support.

Provide grave prognosis to the family.Families need time to accept what has happened to their loved one. Be consistent in your message and work with the LiveOnNY staff member to determine the best time to tell the family about donation.

Huddle!An established national best practice is taking the time to meet as a group. As a multi-disciplinary care team that includes the hospital and LiveOnNY staff, it is important for all involved with the care of the potential donor to discuss and communicate management, declaration and family care plan.

When Are Families Told About Donation?

A LiveOnNY representative will go to the hospital. The family will be told about donation:

- After the patient has been determined to be a suitable candidate and brain death testing has begun; or

- After the hospital has approved withdrawal of life-sustaining interventions.

The LiveOnNY representative works with hospital staff to provide emotional support to the family. In the case of brain death, he/she helps the family understand that their loved one is dead.

Collaboration between LiveOnNY and hospital staff is imperative to the process to ensure the respect of the potential donor family’s loss while assuring that other lives are saved.

For potential tissue donors only:

The family is contacted at home by aLiveOnNY representative, and told about the following types of donation: Corneas, bone with associated tissues of the upper and lower extremities including the hip, skin, saphenous veins and femoral veins.

You can help by asking the family for a telephone number where they can be reached.

This will enable LiveOnNY to act quickly and avoid the removal of the patient’s body by the funeral home or the medical examiner prior to donation.

Who Can Authorize Donation?

Designated Donors: These are potential organ and/or tissue and eye donors who have previously documented legally binding consent to donate; for example, by enrolling in the New York State Donate Life Registry. In such cases, the family members or other authorized person will be notified prior to proceeding with donation.

Non-Designated Donors: These are potential organ and/or tissue and eye donors who have not previously documented legally binding consent to donate. In such cases, the legal members or authorized person is approached.

Authorized Persons: New York State law stipulates the following order of priority for individuals to make decisions about donation when someone has died:

A designated Health Care Agent

An agent for the disposition of remains (burial agent)

Spouse or a patient's domestic partner if there is no spouse or the spouse is legally separated from the patient

Adult Children

Parents

Adult Siblings

Guardian

Any other person authorized or under the obligation to dispose of the body

Out of Tragedy, Something Positive

Unexpected death is countered with life-saving donation, a positive act that offers some comfort to families.

When a loved one’s prior decision to be a donor is legally documented, donor families find solace knowing they are complying with their loved one’s decision.

When there is no prior legal documentation, next-of-kin attest to the fact that they feel a sense of meaning when they authorize donation. They are comforted in their belief that the act of donation is something their loved one would have wanted because it reflects their lifestyle and values.